| Horizon Family Medicine Center Llc | |
|
3737 N Meridian St Ste 501 Indianapolis IN 46208 | |
| (317) 493-1053 | |
| (317) 426-2208 |
| Full Name | Horizon Family Medicine Center Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3737 N Meridian St Ste 501, Indianapolis, Indiana |
| Authorized Official Name and Position | Jude J Momodu (CEO) |
| Authorized Official Contact | 3174931053 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Horizon Family Medicine Center Llc 3737 N Meridian St Ste 501 Indianapolis IN 46208-4383 Ph: (317) 493-1053 | Horizon Family Medicine Center Llc 3737 N Meridian St Ste 501 Indianapolis IN 46208 Ph: (317) 493-1053 |
| NPI Number | 1295089621 |
|---|---|
| Provider Enumeration Date | 11/07/2012 |
| Last Update Date | 06/03/2020 |
| Medicare PECOS PAC ID | 7719123801 |
|---|---|
| Medicare Enrollment ID | O20130416000182 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295089621 | NPI | - | NPPES |
| 15D2052802 | Other | IN | CLIA (CMS) |
| 1295089621 | Other | IN | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | 01057399A (Indiana) | Primary |
| Provider Name | Jude Jimmy Momodu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912924549 PECOS PAC ID: 5092709154 Enrollment ID: I20040412001145 |
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